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Develop a data table that illustrates one or more underperforming clinical outcomes in a care environment of your choice. Write an assessment (35 pages) in which you set one or more quantitative goals for the outcomes and propose a change plan that is designed to help you achieve the goals.
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.
Knowing what is the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients.
The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For, if we cannot effectively implement changes in practice or procedure, than our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.
This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
o Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
Competency 2: Develop change strategies for improving the care environment.
o Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
o Justify the specific change strategies used to achieve desired outcomes.
Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care.
o Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
o Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
o Communicate change plan in a way that makes the data and rationale easily understood and compelling.
o Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
CONTEXT
One area in health care that it is necessary to consider is the environment in which the nurse works. It is important that this environment evolves and changes so that all patients are adequately supported. For this assessment, you will develop a change strategy to improve the health care environment. These changes can be rooted in a desire to improve clinical outcomes and data related to assessment accuracy, drug administration, disease recovery rates, or another relevant metric or outcome. A key skill for master’s-level nurses is to be able to evaluate clinical data and create a change plan to help drive improvements in the data to reach set goals.QUESTIONS TO CONSIDER
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
The assessment will be based on one or more outcomes that you would like to see improve. Think about experiences you have had working on setting goals for outcomes or using data to identify areas of need. Part of achieving your goal will be your ability to implement change in pursuit of improving outcomes. The Vila Health: Using Evidence to Drive Improvement simulation may be helpful in this regard.
Where do you look for resources and evidence to help you get started when treating a specific condition?
Where do you look for resources and evidence to help you get started when setting clinical goals?
o When there are no guidelines or policies for setting clinical goals, where do you look for resources and evidence to help you get started?
How do you use these resources and evidence to begin constructing evidence-based treatment, or developing evidence-based goals?
What data do you plan to use as a basis for setting improved outcome goals?
o What care environment do you envision using as the context of your assessment?
o How would change models, strategies, or theories need to be applied to help ensure achievement of your outcome goals?
o Which change models, strategies, or theories seem to be the best fit for your goals and environments. Why?
ASSESSMENT INSTRUCTIONS
Scenario
Consider the current environment. This could be your current care setting, the care settings presented in the Vila Health: Using Evidence to Drive Improvement or Vila Health: Concept Maps as Diagnostic Tools media, or a care setting in which you are interested in working.
For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course (Vila Health: Using Evidence to Drive Improvement), a relevant data set that already exists (a data set from the case study you used as a basis for your Concept Map assessment, or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)
After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal.
Potential topics for this assessment could be:
Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your Concept Map assessment. As a starting point you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”
Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point you could ask yourself, “How could the care environment be changed to enhance coping?”
Once you determine the change you would like to make, consider the following:
What data will you use to justify the change?
How can the team achieve this change with a reasonable cost?
What are the effects on the workplace?
What other implementation considerations do you need to consider to ensure that the change strategy is successful?
How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals?
Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?
Instructions
Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation to better understand how each grading criterion will be assessed.
Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
Justify the specific change strategies used to achieve desired outcomes.
Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
Communicate the change plan in a way that makes the data and rationale easily understood and compelling.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Additional Requirements
Length of submission: 35 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.
Number of references: Cite a minimum of 35 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.
APA formatting: Use the APA Paper Template linked in the Resources. An APA Template Tutorial is also provided to help you in writing and formatting your analysis. No abstract is required.
RESOURCES
Suggested Resources
The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid.
Assessment
Komenan, K., Elidj, E. J., Ildevert, G. P., Yao, K. I., Kanga, K., Kouam, K. A., . . . Kanga, J. (2013). Multifocal buruli ulcer associated with secondary infection in HIV positive patient. Case Reports in Medicine, 2013, 14. Retrieved from https://www.hindawi.com/journals/crim/2013/348628/ (PLEASE USE WEBLINK TO VIEW)
Biopsychosocial
Scaramuzzo, L. A., Gordils-Perez, J., & Cullen, P. M., (2014). Getting patients active: Using national data to drive practice. Clinical Journal of Oncology Nursing, 18, 4143. (THIS WILL BE IN ADDITIONAL FILES )

Change
Eads, V., & Maruzzella, G. (2016). The clinical nurse as an agent of change. Medsurg Nursing, 25(3), 173175. (THIS WILL BE IN ADDITIONAL FILES )

Heinig, M. J. (2010). Using data to drive and shape change. Journal of Human Lactation, 26(4), 359361. (THIS WILL BE IN ADDITIONAL FILES )

Nundy, S., Mishra, A., Hogan, P., Lee, S. M., Solomon, M. C., & Peek, M. E. (2014). How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study. The Diabetes Educator, 40(6), 806819. (THIS WILL BE IN ADDITIONAL FILES )

Evidence and Goal Setting
Ahrens, S., & Johnson, C. S. (2013). Finding the way to evidence-based practice. Nursing Management, 44(5), 1519.
Taylor, M. V., Priefer, B. A., & Alt-White, A. C. (2016). Evidence-based practice: Embracing integration. Nursing Outlook, 64(6), 575582. (THIS WILL BE IN ADDITIONAL FILES )

View the simulation Vila Health: Using Evidence to Drive Improvement | Transcript. (THIS WILL BE IN ADDITIONAL FILES )

Pathophysiology
Li, Y., Lu, Z., Zhang, X., Yu, H., Kirkwood, K. L., Lopes-Virella, M. F., & Huang, Y. (2015). Metabolic syndrome exacerbates inflammation and bone loss in periodontitis. Journal of Dental Research, 94(2), 362370.
Mocan Hognogi, L. D., & Simiti, L. V. (2016). The cardiovascular impact of visfatin – An inflammation predictor biomarker in metabolic syndrome. Clujul Medical, 89(3), 322326. (THIS WILL BE IN ADDITIONAL FILES )

Pharmacology
Sharmila, V., & Babu, T. (2015). Oral contraceptive pills induced hemichorea in an adolescent female with polycystic ovarian disease. Indian Journal of Pharmacology, 47(2), 232233. (THIS WILL BE IN ADDITIONAL FILES )

Course Files and Templates
Guiding Questions: Change Strategy and Implementation [DOC]. (THIS WILL BE IN ADDITIONAL FILES )

Write a response to the following to paragraph: (each around 150 words)1,The Ethnographer’s Magic
COLLAPSE
Bronislaw Malinowski was one of the pioneering anthropologists of the 20th century. A generation of anthropologists looked up to him as the father of positivist anthropology. He championed participant observation as the only way to get into the mind of the “savage.” When his diaries were released, it shattered a myth of anthropology- that of the unbiased researcher. How did Malinowski’s upbringing, his culture, affect his fieldwork? How did his private diaries function in that fieldwork? How do you think you’d react if thrust into another culture? Or have you been? Do you think you could be an unbiased observer?
2, Steel Axes for Stone Age Australians
COLLAPSE
What were some of the cultural values attached to stone axes by the Yir Yuront? How did the introduction of steel axes by missionaries alter those values? How did these changes affect Yir Yuront culture? Finally, can we really predict the outcome of our interactions with other cultures?

Write a 750- to 1,050-word paper on fraud auditing and IT auditing.Describe the different kinds of fraud andthe Fraud Triangle, an auditor’s responsibility to identify and assess fraud.
Describe the specific risks, benefits, and internal controls associated with IT functions.
Please include references

Examiners will not read anything beyond the allowable word limit i.e. any excess words will be deemed as not included in the assessment. All assignment questions are approved by the External Examiner and all assignments submitted must clearly identify which approved question is being answered. YOU MUST ANSWER A SET QUESTION. If your essay does not clearly identify the question being addressed, or is written to address a different question than the approved list, it will be treated as a fail. Make sure this is edited thoroughly and please stick to the topic at hand, the word count is generous but no repetition or redundant points. Pay close attention to the word critically asses. I’ve uploaded a lot of readings for you to look at and use they will give you all you need, feel free to add more.

How did you become interested in social work? What motivated you to choose social work as a profession?
2. Describe some traits and abilities that make you particularly suited for the profession of social work.
3. Specify your career objectives as a professional social worker.
4. Describe your professionalsocial work activities. If you do not currently work in the social work field, describe how
your work or volunteer experience relates to professionalsocial work activities. Please be as specific as possible in
detailing the similarity to social work activities.
5. Describe a situation in which you were confronted with an ethical conflict. How did you resolve it?
6. Our School of Social Work has a strong multicultural emphasis and values diversity. Please describe your
experience(s) with diverse individuals and/or communities. (Differences can include age, socioeconomic status, race,
ethnicity, religion, gender, physical or mental abilities, sexual orientation, etc.). Discuss how these experiences have:
Shaped your identity and self-awareness
Broadened your understanding of the role of social work in society
Influenced your understanding of and commitment to social justice
7. Discuss a social problem of interest to you. How do you envision a social workers role in addressing the issue?
8. Please read the information about our MSW program below and describe your plan to accommodate the class and
field internship requirements and expected demands of our MSW program.

Topic: Decision Making in Mitigation StrategiesAs mentioned in Week 3, mitigation strategies are short- or long-term measures to eliminate or significantly reduce the impact of a potential hazard. Although mitigation activities can reduce or eliminate threats, mitigation can create new hazards or increase the impact of certain types of events. Mitigation can also create a false sense of safety. For example, builders might be tempted to build in a flood plain if they think a levee or dam will protect the structures from flood waters.Equity issues can surface when approaching mitigation activities. For example, mitigation is often expensive and it can be difficult to garner funding for low socioeconomic areas that have less political influence and economic value. There are also social concerns that need to be considered. What assets in a community should be protected? What if flood plain buyouts consist of poor areas or neighborhoods? Is there another motive behind the buyout? Such questions need to be approached by emergency managers and communities with both sensitivity and a proper understanding of all impacts of mitigation. Because of the difficult decisions that need to be made when planning mitigation activities, it is important that individuals are motivated to advocate for needed mitigation in their own communities.For this Discussion, view the media in this weeks Learning Resources and review the scenario provided below. Consider the mitigation approach you might take. Also think about how you might motivate the community to take action to mitigate for future disasters.Scenario: A community needs to increase its tax base by encouraging the growth of business. The area of land selected for development is subject to 100-year floods (i.e., one event occurring within 100 years). You, as the emergency manager, have been asked to address the city council about possible hazard mitigation strategies.With these thoughts in mind:(The Assignment)
Post a brief explanation of mitigation strategies you might use to reduce loss of life, injuries, and destruction of property in the scenario you selected. Then explain your rationale for selecting those strategies. Finally, explain how you might motivate the community in the scenario to take appropriate action to advocate for mitigation from future disasters.Be sure to support your postings and responses with specific references to the Learning Resources and the current literature.

On your OTCAS account, complete a personal statement that should address why you selected OT as a career and how an Occupational Therapy degree relates to your immediate and long-term professional goals. Describe how your personal, educational, and professional background will help you achieve your goals. The personal essay is an important part of your application for admission and provides you with an opportunity for you to clearly and effectively express your ideas.

Evaluate how effective WSU’s sexual assault website (https://oeo.wsu.edu/sgbv/) is at preventing sexual assault and supporting victims. Find one additional example from any other university and compare the websites. Utilizing what you learned from the book Unsafe in the Ivory Tower, which website do you think does a better job of informing students about sexual assault on campus and supporting victims after the assault has occurred? Is there anything you would add to or take away from WSU’s sexual assault website? It does not have to be in APA and does not need a title page and a reference page.

An analyst of the role played by intelligence in the Second World War writes: If the Axis had possessed the best intelligence and the Allies the worst, the Allies still would have won. Do you agree with this assessment? The answer should be from this reference: 1. Murray, Williamson and Alan R. Millett. A War to Be Won: Fighting the Second World War. Cambridge: Harvard University Press, 2000. Pages 1-142, 262-335, 374-483. [Murray and Milletts narrative history of the Second World War focuses on the operational level of war. The selections assigned to cover the entire war in Europe from its inception in September 1939 until the surrender of Germany in May 1945.] 2. Matloff, Maurice. Allied Strategy in Europe, 1939-1945. In Makers of Modern Strategy: From Machiavelli to the Nuclear Age, edited by Peter Paret. Princeton: Princeton University Press, 1986. Pages 677-702. 3. The Anglo-American Strategic Controversy, 1941-43. (Selected Readings) [These primary documentsa proposed strategy by the British Chiefs of Staff in December 1941, a counterargument in effect written by General Marshall around March 1942, a September 1943 discussion between American and British military leaders, and an account of the first meeting between Roosevelt, Churchill, and Stalin at Tehran in November 1943illustrate the critically different strategic concepts held by the British and Americans and show how their dispute was finally resolved.] 4. Hinsley, F. H. The Influence of Ultra in the Second World War. In Codebreakers: The Inside Story of Bletchley Park, edited by F. H. Hinsley and Alan Stripp. New York: Oxford University Press, 1993. Pages 1-13.

Research Paper: Leadership and Management topic Conduct research and write a paper containing the two elements: Part I: Choose one of the listed topics Implementing change on a nursing unit (Student must incorporate an example and a change theory) Leadership traits for successfully managing in the clinical arena. Quality improvement in the nursing unit or system Mentorship in nursing Preceptor programs for nursing leaders Solving incivility in the work place, How can a nurse manager help? (conflict resolution) Legal Issues within the nursing unit Promotion of ethical behaviors within the nursing unit (student must create a plan and implementation strategy) Nursing Unit Strategic Planning Compare and contrast the following new roles for the changing health care arena: o Nurse Navigators, Clinical Nurse Leaders, and Leaders in Patient-Centered Care Part II: Evaluate how the topic applies to 2 of the following course competencies. Integrate concepts related to leadership into the professional nursing role. Analyze the philosophy, goals, and organizational structure of a healthcare system in relationship to the delivery of quality healthcare. Compare selected theories of leadership, management, and organizations in relation to healthcare agencies. Identify how collaborative leadership styles might be utilized in various community agencies to enhance the role of the nurse leader. Examine change theory, change management, conflict resolution, and strategies to promote innovation. Explain principles of continuous quality improvement (CQI) and the process of quality planning, improvement, and control. Discuss the management process and its impact on the delivery of optimal healthcare. Analyze how accountability, advocacy, and collaboration augment the management of care. Describe the meaning of teamwork in respect to the health care team Identify the essential components of a business plan Analyze various organization structure/management theories as they relate to nursing practice In addition to the assignment specifics above, this paper should: Be 3-4 pages, not including the title and reference pages. Source(s) should be integrated into the paragraphs. Use in-text citations pointing to evidence in the literature that supports your ideas. Incorporate a minimum of two (2) peer-reviewed sources into your paper. Use current APA format to style your paper and to cite your sources. Include a title page and a reference page listing the sources you used. Be sure to plan enough time for proofreading and editing. Review the rubric for further information on how this assignment will be graded.